SULLIVAN COUNTY COMMUNITY HOSPITAL (NPI# 1154939320) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154939320 |
| Entity Type | Organization |
| Organization Name | SULLIVAN COUNTY COMMUNITY HOSPITAL |
| Practice Address |
2200 N Section St Sullivan IN 47882-7523 |
| Mailing Address |
Po Box 10 Sullivan IN 47882-0010 |
| Practice Telephone | 8122683318 |
| Mailing Telephone | 8122684311 |
| Enumeration Date | 2020-07-14 |
| Last Update Date | 2020-07-14 |
| Authorized Official Name | DARRELL D WATSON (DIRECTOR OF REVENUE CYCLE) |
| Authorized Official Telephone | 8122684311 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| FPA Quickcare | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366076564 | Sullivan County Community Hospital | Clinic/Center | 4146 S 7th St Ste B, Terre Haute, IN 47802-4123 | 2020-02-26 |
| 1497759260 | Sullivan County Community Hospital | General Acute Care Hospital | 2200 N Section St, Sullivan, IN 47882-7523 | 2005-06-09 |
| 1790788537 | Sullivan County Community Hospital | Home Health | 2110 N Hospital Blvd Ste 3, Sullivan, IN 47882-7656 | 2005-05-24 |
| 1093323701 | Sullivan County Community Hospital | Clinic/Center | 2186 N Hospital Blvd Ste 2, Sullivan, IN 47882-7654 | 2020-07-20 |
| 1497363303 | Sullivan County Community Hospital | Family Medicine | 2186 N Hospital Blvd Ste 2, Sullivan, IN 47882-7654 | 2020-07-16 |
| 1447805965 | Sullivan County Community Hospital | Family Medicine | 2229 Mary Sherman Dr, Sullivan, IN 47882-7633 | 2019-08-02 |
| 1467884643 | Sullivan County Community Hospital | Clinic/Center | 2229 Mary Sherman Dr, Sullivan, IN 47882-7633 | 2013-07-30 |
| 1275827206 | Sullivan County Community Hospital | Clinic/Center | 8685 Old Highway 41 South, Carlisle, IN 47838-8234 | 2011-06-07 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SULLIVAN COUNTY COMMUNITY HOSPITAL | 2200 N Section St, Sullivan, IN 47882-7523 |
| Indiana Business Entities | SULLIVAN COUNTY COMMUNITY HOSPITAL | Formed Pursuant To Ic 16-22-8-6, "other Entity" Under 23-15-1-5-, To Provide for Assumed Name, ., IN |
| Street Address |
2200 N SECTION ST |
| City | SULLIVAN |
| State | IN |
| Zip Code | 47882-7523 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497759260 | Sullivan County Community Hospital | General Acute Care Hospital | 2200 N Section St, Sullivan, IN 47882-7523 | 2005-06-09 |
| 1760018691 | Holly M Clevenger | Social Worker | 2200 N Section St, Sullivan, IN 47882-7523 | 2020-03-23 |
| 1710479084 | Jessica A Dean-hester | Nurse Practitioner | 2200 N Section St, Sullivan, IN 47882-7523 | 2018-06-03 |
| 1902278476 | Jessica Myers | Nurse Practitioner | 2200 N Section St, Sullivan, IN 47882-7523 | 2015-10-23 |
| 1891193314 | Community Medical Imaging Inc | Radiology | 2200 N Section St, Sullivan, IN 47882-7523 | 2014-12-16 |
| 1154741296 | Mso Clinics, Inc. | Clinic/Center | 2200 N Section St, Sullivan, IN 47882-7523 | 2014-04-16 |
| 1063831527 | Mso Clinics, Inc. | Clinic/Center | 2200 N Section St, Sullivan, IN 47882-7523 | 2014-04-14 |
| 1518187012 | Angela Beth Sagarsee | Dietitian, Registered | 2200 N Section St, Sullivan, IN 47882-7523 | 2007-04-26 |
| 1104045871 | Traci Ann Ray | Dietitian, Registered | 2200 N Section St, Sullivan, IN 47882-7523 | 2007-04-24 |
| 1134343122 | R. Vedala and Associates, LLC | Radiology | 2200 N Section St, Sullivan, IN 47882-7523 | 2007-04-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659718336 | Neil Lynn Smith | Dentist | 118 S. Court St., Sullivan, IN 47882 | 2013-06-04 |
| 1184888000 | Mary Sherman Hospital | Hospice Care, Community Based | 817 North Section Street, Suite A, Sullivan, IN 47882 | 2008-07-10 |
| 1003838194 | Johnson Memorial Hospital | Durable Medical Equipment & Medical Supplies | 505 West Wolfe Street, Sullivan, IN 47882 | 2006-07-24 |
| 1255580593 | Daniel Choyce Callahan | Psychiatry & Neurology | 2204 N Section St, Sullivan, IN 47882 | 2008-09-11 |
| 1851394175 | Van Evanoff Jr. | Pain Medicine | 2204 N Section St, Suite B, Sullivan, IN 47882-0010 | 2005-05-31 |
| 1982780748 | Associated Physicians & Surgeons Clinic, LLC | Obstetrics & Gynecology | 2204 N Section St, Suite B, Sullivan, IN 47882-0010 | 2006-10-27 |
| 1871996199 | Sullivan Family Dentistry, LLC | Dentist | 2186 N Hospital Blvd., Suite 1, Sullivan, IN 47882-0468 | 2014-10-01 |
| 1487828455 | Kortni Reann Martindale | Speech-Language Pathologist | 368 W Indiana Ave, Sullivan, IN 47882-1117 | 2008-04-21 |
| 1831280585 | Southwest School Corporation | Local Education Agency (LEA) | 110 N Main St, Sullivan, IN 47882-1225 | 2006-09-27 |
| 1780717637 | Brian K Grindstaff | Chiropractor | 210 N Section St Unit C, Sullivan, IN 47882-1237 | 2007-03-13 |
| Find all providers in zip 47882 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093323701 | Sullivan County Community Hospital | Clinic/Center | 2186 N Hospital Blvd Ste 2, Sullivan, IN 47882-7654 | 2020-07-20 |
| 1962878488 | Thera-peds, LLC | Clinic/Center | 115 Progress Pkwy, Sullivan, MO 63080-2359 | 2015-08-19 |
| 1063831527 | Mso Clinics, Inc. | Clinic/Center | 2200 N Section St, Sullivan, IN 47882-7523 | 2014-04-14 |
| 1215945480 | Missouri Baptist Hospital of Sullivan | Clinic/Center | 751 Sappington Bridge Rd, Sullivan, MO 63080-2354 | 2006-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629679170 | Gentlemind Health Services | Clinic/Center | 3635 Lake Ave, Fort Wayne, IN 46805-5539 | 2020-11-02 |
| 1063021129 | Affordable Lab Solutions | Clinic/Center | 1121 16th St, Bedford, IN 47421-3721 | 2020-07-24 |
| 1568071710 | Ivx Health of Indiana PC | Clinic/Center | 9510 N Meridian St Ste D, Indianapolis, IN 46260-1333 | 2020-07-23 |
| 1346867942 | Henry County Memorial Hospital | Clinic/Center | 4760 National Rd W, Richmond, IN 47374-4745 | 2020-06-30 |
| 1114541935 | Ourhealth Physicians Group, LLC | Clinic/Center | 9998 N Michigan Rd, Carmel, IN 46032-9640 | 2020-06-08 |
| 1366076564 | Sullivan County Community Hospital | Clinic/Center | 4146 S 7th St Ste B, Terre Haute, IN 47802-4123 | 2020-02-26 |
| 1497306310 | Activate Healthcare - Ibew Local 153/ua Local 172 South Bend | Clinic/Center | 3371 W Cleveland Road Ext Ste 120, South Bend, IN 46628-9780 | 2019-09-23 |
| 1437707601 | Nuyou Therapies, LLC | Clinic/Center | 5401 Vogel Rd Ste 740, Evansville, IN 47715-7834 | 2019-08-29 |
| 1306492160 | Deaconess Clinic, Inc. | Clinic/Center | 315 N 1st Ave, Evansville, IN 47710-1218 | 2019-08-16 |
| 1750941902 | Unity Healthcare LLC | Clinic/Center | 1345 Unity Pl Ste 220, Lafayette, IN 47905-5761 | 2019-06-19 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.